Reproductive and Assisted Reproductive Technology (ART) Outcomes in East Asian Women

Abstract

Health disparities research in women’s reproductive health is evolving and racial disparities have emerged in many areas including in assisted reproductive technology (ART) and reproductive aging in Asian women compared to Caucasians. Observed differences in East Asian women may reflect true biologic differences because of genetic background or may result from various environmental exposures, lifestyle factors, cultural factors, access to care, and specifics of treatments once care has been accessed. All of the studies investigating the disparities in ART outcomes between Asian and Caucasian women demonstrated significantly low implantation, clinical pregnancy, and live birthrates in Asian women using autologous eggs. Higher peak estradiol levels during the ovarian stimulation creating glandular–stromal dyssynchrony may be one of the explanations of the worse pregnancy outcomes in Asian women. Later age of natural menopause and lower prevalence of premature ovarian failure have been reported in some East Asian populations compared to Caucasians. There are still major knowledge gaps in our understanding of these racial and ethnic disparities in East Asian women. Further research to improve our understanding of the source of these disparities is critical to optimizing the delivery of reproductive care across our increasingly diverse society.